Groin hernias are typically characterized as indirect inguinal hernias, direct inguinal hernias, and femoral hernias. It is known to repair such hernias by covering the defect with a prosthetic repair patch. In the classic ‘Lichtenstein’ procedure, the patch is placed anteriorly of the transversalis fascia. Alternatively, the patch may be positioned posteriorly of the transversalis fascia, for example, in the preperitoneal space between the transversalis fascia and the peritoneum.
A prosthetic repair patch may be delivered laparoscopically to the preperitoneal space in a procedure known as TEP—“Totally Extra Peritoneal”. Alternatively, a prosthetic repair patch may be placed in the preperitoneal space via an ‘open’ procedure.
Two common open procedures for preperitoneal placement of a prosthetic repair patch include the POLYSOFT Hernia Patch procedure and the Kugel procedure. In the POLYSOFT approach, access to the preperitoneal space is through the defect itself. In the Kugel procedure, an opening is formed directly through the three layers overlying the preperitoneal space—the external oblique aponeurosis, the internal oblique aponeurosis, and the transversalis fascia. In both the POLYSOFT procedure and the Kugel procedure, the prosthetic repair patch is positioned in a single tissue plane between the peritoneum and the transversalis fascia.
Another open procedure for mending a groin hernia is the ONSTEP procedure which involves placement of a prosthetic repair patch in two different tissue planes. A medial portion of the patch is placed in the preperitoneal space and a lateral portion of the patch is placed in a tissue plane anteriorly of the transversalis fascia with a segment of the patch extending through the transversalis fascia.
It is an object of the present invention to provide a prosthesis for mending defects in soft tissue and muscle walls.